糖调节受损合并后循环短暂性脑缺血发作患者脑干听觉诱发电位研究

Influence of impaired glucose regulation on brainstem auditory evoked potential after posterior circulation transient ischemic attack

目的:通过检测糖调节受损(IGR)合并后循环短暂性缺血发作(TIA)患者脑干听觉诱发电位(BAEP)变化,探讨IGR合并后循环TIA患者BAEP的受损特点。方法:选择2016年1月至2019年4月于广东省人民医院南海医院神经内科住院的后循环TIA患者150例,包括糖尿病(DM)合并后循环TIA患者50例(合并DM组)、IGR合并后循环TIA患者50例(合并IGR组)和非糖尿病合并后循环TIA患者50例(无DM组),同时选取50例健康志愿者作为对照组。全部患者发病48 h内均行BAEP检查,比较3组患者的BAEP异常发生率以及主波Ⅰ、Ⅲ、Ⅴ波波峰潜伏期(PL)、峰间潜伏期(IPL)及Ⅲ~Ⅴ/Ⅰ~Ⅲ的IPL比值等特点。结果:合并DM组、合并IGR组和无DM组的BAEP异常率分别为88.0%(44/50例)、80.0%(40/50例)、60.0%(30/50例),差异有统计学意义(P<0.05)。3组后循环TIA患者的主波Ⅰ、Ⅲ、Ⅴ的PL及IPL均较对照组延长(P<0.05);合并DM组、合并IGR组Ⅲ、Ⅴ主波PL及Ⅲ-Ⅴ的IPL较无DM组明显延长(P<0.05)。3组后循环TIA患者Ⅲ~Ⅴ/Ⅰ~Ⅲ的IPL比值差异无统计学意义(P>0.05)。结论:合并IGR的后循环TIA患者脑干功能损害较无DM的TIA患者更容易受到缺血影响,即使在IGR阶段,血糖升高都将加重脑干功能损伤,不单单限于DM患者人群。

Objective:To explored the changes of brainstem auditory evoked potential(BAEP)in patients with impaired glucose regulation and posterior circulation transient ischemic attack(TIA),and investigate the characteristics of BAEP.Methods:One hundred and fifty patients with posterior circulation TIA,including 50 patients with diabetes mellitus(DM)combined with posterior circulation TIA(DM group),50 patients with IGR combined with posterior circulation TIA(IGR group)and 50 non-diabetes patients with posterior circulation TIA(non DM group).50 healthy volunteers were enrolled as the control group.BAEP was performed in all patients within 48 h of onset.The abnormal incidence of BAEP,Peak latency(PL)and interpeak latency(IPL)of main waveⅠ,ⅢandⅤand IPL ratio ofⅢ~Ⅴ/Ⅰ~Ⅲwere compared among the three groups of TIA patients.Results:The abnormal rate of BAEP was 88.0%(44/50 cases),80.0%(40/50 cases)and 60.0%(30/50 cases)in DM group,IGR group and non DM group respectively,with statistically significant(P<0.05).The PL and IPL of main waveⅠ,ⅢandⅤin the three groups were longer than those in the control group(P<0.05).The PL of main waveⅢandⅤand IPL of main waveⅢ-Ⅴin DM group and IGR group were significantly longer than those in non DM group(P<0.05).There was no significant difference in the IPL ratio ofⅢ~Ⅴ/Ⅰ~Ⅲamong the three groups of TIA patients(P>0.05).Conclusions:The brain stem function damage of TIA patients with IGR is more vulnerable to ischemia than that of TIA patients without DM.Even in the IGR stage,the increase of blood glucose will aggravate the brain stem function damage,not only in DM patients.